UNCONTROLLED WHEN PRINTED
Introduction
  • Olanzapine is a second generation antipsychotic agent that acts on multiple receptors (incl. serotonin and dopamine receptors), resulting in sedation
  • Onset of effect usually ~ 10 mins.
Indications
  • Disturbed and Abnormal Behaviour (RASS 1 ~ 2) where risk to safety is evident and the patient is able to tolerate or self-administer an oral wafer
  • Preferred first line sedation agent in frail patients and those with Dementia
Contraindications
  • Known Allergy
  • Known Parkinsons Disease
  • < 6 years of age
Precautions / Notes
  • Sedation of any patient < 16 years of age –should prompt a prior ASMA consult wherever practicable.
  • Organic causes such as suspected sepsis, traumatic brain injury or spontaneous intra-cranial event must be considered unlikely
  • ‘Agitated or Excited Delirium’, ‘Acute Behavioural Disturbance’ and ‘Drug Induced Psychosis’ are some alternative terms that may be used by other agencies
  • Effects may be amplified in patients with alcohol intoxication
  • Oral dispersible tablet may be dissolved in water (may slightly delay onset of action but still preferable in non-emergent cases)
  • Early monitoring as soon as practicable is required when administering Olanzapine; including SpO2, respiratory rate, pulse and blood pressure
  • SpO2 and etCO2 monitoring must be applied whenever level of consciousness drops (~RASS < 0)
Management

Adults < 70 years old:

  • 10mg
  • Repeat once only after 15 mins if indicated to total maximum cumulative dose via all routes 20mg/24hrs.

Adults > 70 years old or frail:

  • 5mg
  • Repeat once only after 15 mins if indicated to total maximum cumulative dose via all routes 10mg/24hrs.

Paediatric 6 - 15 years old, > 40kg:

  • 5 - 10mg
  • Repeat once after 15mins if indicated to a total maximum cumulative dose via all routes 20mg/24hrs.

Paediatric < 40kg

  • ASMA consult required
Special Considerations
  • Extrapyramidal effects / Dyskinesia
  • Increased falls risk
  • Hypotension – Apply monitoring as soon as practicable

References
References
Presentation

5mg Oral Dispersible tablets in blister pack

OLZ1

Colour assist:

Document Control


Directorate
Clinical Services

Responsible Manager
Head of Clinical Services

Date of Issue

Date of Expiry

St John WA © Copyright 2020. All Rights Reserved

Privacy Policy | Copyright Statement & Disclaimer